Form to Document New York State Professional Licensure Exemption

Form New York State Professional Licensure Exemption is a document used to apply for a professional licensure exemption for the state of New York.

The form consists of several sections. The first section is 'Applicant Information' which asks for the applicant's name, address, telephone number, email address, and social security number. The second section is 'Exemption Request'. This section requires the applicant to specify the type of profession for which they are seeking an exemption, as well as details regarding the applicable state law or regulation. The third section is 'Statement of Exemption Request'. Here the applicant must state their justification for the exemption and provide information about their education, training, and experience, which qualifies them for the exemption. The fourth section is 'Work History'. This section requires the applicant to provide details of their work history, including positions held, employers, and locations. The fifth section is 'References'. This section requires the applicant to provide the contact information of two professional references. The sixth section is 'Signature'. Here the applicant must sign and date the form in order for it to be considered valid.

Important fields in this form include the 'Exemption Request' section, 'Statement of Exemption Request' section, and the 'References' section. The 'Exemption Request' section is important as it is used to determine the type of exemption being requested. The 'Statement of Exemption Request' section is important as it must be filled out in detail to demonstrate why the applicant is eligible for the exemption. The 'References' section is important as the references provided must be able to vouch for the applicant's qualifications.

An example situation where this form would be used is if a person has the necessary qualifications for a certain profession, but does not meet the licensure requirements. They would fill out this form to apply for an exemption from the requirements. Specific instructions for completing the form include filling out all sections with accurate and up-to-date information. The purpose of completing the form is to receive an exemption from the New York State professional licensure requirements.

Related forms may include the New York State Professional Licensure Renewal form, the New York State Professional Licensure Application form, and the New York State Professional Licensure Amendment form. Additional documents that may be needed for filling out